CMS hopes a revised advisory opinion process will attract more requestors

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers CMS’s revised Stark physician self-referral advisory opinion process and the operational changes tied to the 2020 Medicare physician fee schedule final rule. It is relevant to physicians, compliance staff, attorneys, and other health care stakeholders who monitor self-referral issues, advisory opinion procedures, and related CMS guidance. The discussion focuses on process timing, request requirements, fees, and CMS’s approach to opinions involving comparable arrangements.

Why This Topic Matters

The article helps readers understand how CMS is changing the advisory opinion pathway for Stark law compliance and what those procedural updates may mean for organizations seeking guidance on physician self-referral arrangements.

Article Sections

  1. What’s stayed the same

    This section outlines the parts of CMS’s advisory opinion authority and request process that remain unchanged. It also describes the general limits on the kinds of matters CMS will consider.

  2. What will change

    This section summarizes the procedural updates CMS is making to the advisory opinion process. It covers timing, fees, and the new approach to requests involving arrangements similar to those addressed in prior opinions.

  3. Additional guidance and resources

    This section points readers to additional CMS information channels and support resources. It also notes where stakeholders can seek general assistance related to physician self-referral matters.

What You Will Learn

  • How CMS is revising the advisory opinion process for Stark self-referral issues
  • Which parts of the process remain unchanged and which will be updated
  • What categories of requests CMS will and will not consider
  • How the new timeline and fee structure affect advisory opinion requests
  • What general resources CMS directs stakeholders to for self-referral questions

Who Should Read This

  • Physicians
  • Health care compliance professionals
  • Health care attorneys
  • Medical practice administrators
  • Revenue cycle and regulatory affairs staff

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